DOCTOR-DOCTOR COMMUNICATION IN A RADIOLOGY RESIDENCY

The purpose of this study is to describe and analyze how the process of communication between physicians is taught by medical faculty in a university teaching hospital. The students are radiology resident physicians. Through interviews and observations, the investigator focuses on both faculty members' perceptions of teaching the process and the residents' perceptions of being taught.;The findings indicate the complexities of teaching adults in a clinical setting. The physical environment was organized to provide care to patients and only secondarily to teach residents the fundamentals of medical communication. Teaching styles as evidenced by observations and by subjects' definitions of teaching and manner varied greatly ranging from treating residents with arrogance to interacting with them as junior collegues. The individual faculty members intended to teach the residents how to work, teaching was perceived as a means to that end. Communication was perceived as a critical component of the practice of radiology, but not something which warranted specific teaching. The apprenticeship model of teaching employed in the setting succeeded in teaching residents how to communicate with referring physicians. Residents' perceptions of the teaching process differed in many respects from that of the faculty. The social organization of the residency was constructed largely by the faculty. The faculty said they evaluated the residents' communication skills; the residents said they had no evidence of it. The faculty and residents were mainly concerned with adapting to the demands of external forces: the medical services marketplace dictated a priority of business over teaching; the demands of referring physicians dictated the structure of the report communication process, and the faculty's desire to teach the residents how to work dictated the role of the resident.;The description of teaching which emerged from this study could provide the basis for a bottom-up developoment of a model for clinical teaching.;The research problem deals with the similarities and differences of faculty and resident perceptions of the teaching of the report communication process. The research questions deal with the topics of: definitions of teaching, and faculty/resident perceptions of intention, significance, manner, success, and effects of the setting.